Indirect bonding trays, non-sliding orthodontic appliances, and registration systems for use thereof

ABSTRACT

Non-sliding orthodontic appliances may include an archwire having male fasteners for locking in place with brackets in a non-sliding manner and interproximal loops for exerting forces on the brackets. Appropriate forces may be calculated according to vectors between initial and ideal tooth positions. The brackets may be transferred to a patient&#39;s teeth using indirect bonding trays which contain slots for holding and aligning each bracket. The trays may include integrated handles for facilitating handling, may be sectioned into smaller pieces for easier application, and/or may be labeled for facilitating proper registration. Superposition of a digital placement plan and clinical model after bonding may illustrate the accuracy of bracket placement. The archwire may comprise atraumatic ends to avoid patient discomfort. A color registration system can be used to facilitate the attachment of the archwire to the brackets. The archwire may be locked into place with the brackets using crimpable stops.

REFERENCE TO RELATED APPLICATIONS

This application claims the benefit under 35 U.S.C. § 119(e) as anon-provisional application of U.S. Prov. App. No. 62/488,656 filed onApr. 21, 2017, which is hereby incorporated by reference in itsentirety. Any and all applications for which a foreign or domesticpriority claim is identified in the Application Data Sheet as filed withthe present application are hereby incorporated by reference under 37CFR 1.57

BACKGROUND Field of the Invention

The invention relates in some aspects to orthodontic appliances,including brackets, archwires, and bonding trays.

SUMMARY

Disclosed herein is an indirect bonding tray for transferringorthodontic brackets to a patient's teeth. The indirect bonding tray hasa tray having a lingual, occlusal and buccal side formed from a moldablematerial and configured to be seated on at least a portion of thepatient's dental arch. The tray includes at least one impression of atleast one of the patient's teeth and at least one placeholder slotaligned with the at least one impression configured to hold anorthodontic bracket. The tray has one or more handles extending from theocclusal side of the tray. The one or more handles are configured to begrasped by a tool for insertion into the patient's mouth.

The one or more handles may extend along only a portion of the length ofthe tray extending along the dental arch. The one or more handles mayinclude a plurality of handles. A first handle of the plurality ofhandles may be positioned on a left distal side of the tray and a secondhandle of the plurality of handles may be positioned on a right distalside of the tray. A medial anterior portion of the tray may be free ofhandles. The one or more handles may have an aperture extending throughthe handle from the lingual side to the buccal side of the tray. Theaperture may be configured to receive a dental tool for grasping thetray. The one or more handles may form a tunnel extending along a lengthof the handle extending along the dental arch.

The tray can be marked with indicia prescribing treatment information.The treatment information may include information registering portionsof the tray to anatomical locations of the patient's teeth. Theinformation may register the tray to the upper or lower mandible. Theinformation may register a portion of the tray to the right or left sideof the patient's mouth. The information may register a portion of thetray to a specific tooth. The information may demarcate a suggestedposition for sectioning the tray into separate pieces. The indicia maybe a color. The color may be impregnated into the tray. The indicia maybe an ink, an impression, a relief, an adhesive label, and/or anembedded tag. The indicia may indicate the location of the at least oneimpression. The tray may be configured to be seated on only a partialportion of the patient's dental arch.

Disclosed herein is a kit for transferring orthodontic brackets to apatient's teeth. The kit includes a first indirect bonding tray having alingual, occlusal and buccal side formed from a moldable material andconfigured to be seated on a first portion of the patient's dental arch.The first tray includes at least one impression of one of the patient'steeth and at least one placeholder slot aligned with the at least oneimpression configured to hold an orthodontic bracket. The kit includes asecond indirect bonding tray having a lingual, occlusal and buccal sideformed from a moldable material and configured to be seated on a secondportion of the patient's dental arch. The second tray comprises at leastone impression of one of the patient's teeth and at least oneplaceholder slot aligned with the at least one impression configured tohold an orthodontic bracket.

The first and second indirect bonding trays may each be labeled on asurface of the tray to indicate the proper positioning of the traywithin the patient's mouth. The first indirect bonding tray and/or thesecond indirect bonding tray be or may include any of the features ofthe indirect bonding trays described elsewhere herein.

Disclosed herein is a system for determining the accuracy of theplacement of orthodontic brackets on a patient's teeth. The systemincludes a digital representation of a planned model comprising thepatient's teeth and orthodontic brackets positioned on the patient'steeth in planned positions for orthodontic treatment. The system alsoincludes a digital representation of a clinical model of the patient'steeth comprising the patient's teeth and actual positions of theorthodontic brackets after placement onto the patient's teeth. Thesystem also includes a combined model created by a comparison of thedigital representations of the planned model and clinical model, whereinthe discrepancies in the planned positions and actual positions of theorthodontic brackets are visually discernible from the combined model.

The combined model can be a superimposition of a volume of the plannedmodel and the clinical model. Different portions of a surface of thecombined model may be colored differently to reflect which of theplanned model and the clinical model forms the different portions of thesurface. The combined model may highlight discrepancies between themodels a different color. The combined model may depict discrepanciesbetween surface areas of teeth where brackets are bonded. The combinedmodel may depict discrepancies in three-dimensional volumes of spaceoccupied by brackets. The discrepancies between bracket placements maybe the only discrepancies depicted. The system may further includesoftware configured to generate statistics related to the accuracy ofbracket placement. The software may be configured to collect statisticsover a plurality of patients.

Disclosed herein is a method for determining an appropriate force vectorto correct the positioning of a tooth of a patient. The method includesobtaining a digital model of the patient's teeth. The digital modelincludes coordinates for identifying the initial positioning of a toothto be moved in three-dimensional space. The method includes adjustingthe digital model to reposition the tooth to a corrected positioning anddetermining a travel distance vector between the initial positioning andthe corrected positioning of the tooth. The method includes calculatingthe force vector based at least in part on the travel distance vector,the estimated resistance of the tooth, and the anatomy of the patient'smouth.

The method may further include deforming an archwire to form aninterdental loop configured to exert the force vector on the tooth. Themethod may include adjusting the digital model to reposition a secondtooth to a corrected positioning; determining a second travel distancevector between the initial positioning and the corrected positioning ofthe second tooth; calculating a second force vector based at least inpart on the second travel distance vector, the estimated resistance ofthe second tooth, and the anatomy of the patient's mouth; and deformingthe archwire to form a second interdental loop configured to exert thesecond force vector on the second tooth. The method may includecalculating a plurality of force vectors for a plurality of thepatient's teeth. The plurality of force vectors may be configured tomove the plurality of teeth into corrected positions after the sameduration of treatment time.

The initial positioning of the tooth may represent the position of atooth after orthodontic treatment. The method may include obtaining asecond digital model of the patient's teeth after a period of treatmenttime. The model may include coordinates for identifying the updatedpositioning of the tooth after it has been moved in three-dimensionalspace. The method may include measuring an actual travel distance vectorof the tooth and a discrepancy between the actual travel distance vectorand the previously determined travel distance vector. The method mayinclude adjusting the digital model to reposition the tooth to a secondcorrected positioning. The method may include determining a secondtravel distance vector between the updated positioning and the secondcorrected positioning of the tooth. The method may include calculating asecond force vector based at least in part on the second travel distancevector, the estimated resistance of the tooth, and the anatomy of thepatient's mouth, wherein calculating the force vector includes using themeasured discrepancy as feedback to improve the calculation. Using themeasured discrepancy as feedback may include updating the estimatedresistance of the tooth.

Disclosed herein is an orthodontic appliance having a plurality oforthodontic brackets and an archwire. The archwire has a plurality ofmale fasteners for locking into non-sliding engagement with theplurality of orthodontic brackets and at least one interproximal loopconfigured to exert a corrective force on one or more of the orthodonticbrackets. The archwire has atraumatic terminal ends.

At least one atraumatic terminal end may be formed from a terminal loopat a distal end of the archwire. A distal end of the archwire may bebent in an occlusal and/or dental direction. At least one atraumaticterminal end may be formed from a smooth polymeric bulb positioned at adistal end of the archwire. At least one atraumatic terminal end may beformed by a distal end which is not configured to extend distally beyondthe most distal bracket of the plurality of orthodontic brackets. Thedistal-most orthodontic bracket may have an archwire slot configured tolock the archwire within the distal-most orthodontic bracket. Thearchwire slot may not extend to a distal side of the distal-mostorthodontic bracket.

Disclosed herein is an orthodontic appliance having a plurality oforthodontic brackets and an archwire. The archwire has a plurality ofmale fasteners for locking into non-sliding engagement with theplurality of orthodontic brackets and at least one interproximal loopconfigured to exert a corrective force on one or more of the orthodonticbrackets. At least some of the plurality of brackets and at least someof the male fasteners and/or interproximal loops are marked with acolors that distinctly identify which of the at least some of theplurality of brackets is intended to be registered with which of the atleast some of the male fasteners.

The color markings may be temporary. At least some of the plurality ofbrackets may be marked with a removable color insert. The removableinsert may be configured to occupy at least a portion of the archwireslot. The archwire and/or the at least some of the plurality of bracketsmay be marked with a biocompatible dye.

Disclosed herein is an orthodontic appliance having an archwireincluding at least one interproximal loop configured to exert acorrective force an orthodontic bracket and a crimpable stop forengaging with the orthodontic bracket. The crimpable stop is configuredto be crimped so as to secure the archwire to the orthodontic bracket.

The crimpable stop may be a tubular member configured to be receivedover the archwire. Crimping the crimpable stop may prevents thecrimpable stop from sliding with respect to the archwire. The crimpablestop may have a closed circumference and the crimpable stop may beconfigured to be advanced over a distal end of the archwire. Thecrimpable stop may include a slit along the length of the crimpable stopforming a partially-closed circumference. The crimpable stop may beconfigured to be inserted over the archwire via the slit. The length ofthe crimpable stop may correspond to a length of a recess in theorthodontic bracket and the crimpable stop may be configured to preventa portion of the archwire enclosed within the crimpable stop fromsliding mesially or distally beyond the recess. The crimpable stop canbe color coded to indicate which orthodontic bracket it is intended tobe secured within. The orthodontic appliance may include the orthodonticbracket.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A-1C illustrate an example indirect bonding trays. FIG. 1Adepicts an indirect bonding tray having bilateral handles and which hasbeen labeled and sectioned. FIGS. 1Bi-1Bvii schematically illustratevarious configurations of handles to be used with indirect bondingtrays. FIGS. 1Bi-1Bvi illustrate examples of handle cross sections andFIG. 1Bvii illustrates a side view of a handle comprising apertures.FIG. 1C depicts an indirect bonding tray section configured to beapplied to only a portion of a dental arch.

FIGS. 2A-2B schematically illustrate a system and method for comparing aplanned digital model of orthodontic treatment to digital informationrepresenting a clinical model after bonding. The model is superimposedwith the digital information to allow evaluation of the accuracy of theclinical model relative to the planned treatment. FIG. 2B shows aclose-up of the superposition in FIG. 2A.

FIG. 3 illustrates an example of an orthodontic appliance comprising anarchwire and a plurality of orthodontic brackets configured fornon-sliding mechanics.

FIG. 4 illustrates an example of a superimposed model of a single toothcomprising positions from before and after an orthodontic treatment anddemonstrating the actual tooth displacement vector measured by themodel.

FIGS. 5A-5B schematically illustrate examples of archwires comprisingatraumatic terminal ends. FIG. 5A depicts a distal end of an archwirecomprising a terminal loop. FIG. 5B depicts a distal end of an archwirecomprising a bulbous cap.

FIGS. 6A-6B schematically illustrate an example of a crimpable stop.FIG. 6A depicts a crimpable stop positioned within an orthodonticbracket. FIG. 6B depicts an example of an archwire comprising aplurality of crimpable stops positioned between interproximal loops.

DETAILED DESCRIPTION

Orthodontic appliances are used to correct malocclusion of the teeth.Orthodontic appliances generally can include brackets bonded toindividual teeth and an archwire adjoining the brackets for exertingforces between the teeth to bring them into proper alignment.Non-sliding orthodontic appliances may employ an archwire and bracketsthat are configured to lock together such that the archwire is unable toslide relative to the brackets. Non-sliding orthodontic appliances can,in some cases, provide better control over the forces applied to correctthe positioning of the patient's teeth. Archwires used in non-slidingorthodontic devices can include in some cases male fasteners for lockinginto brackets in a non-sliding engagement and interproximal structures,e.g., loops positioned between some and/or each and every male fastenerfor exerting precise corrective forces on adjacent brackets (FIG. 3).Brackets can be applied to a patient's teeth using indirect bondingtrays which hold a plurality of brackets in proper alignment relative tothe patient's teeth

Disclosed herein are systems, methods, and devices for transferring andapplying orthodontic brackets, or other suitable orthodontic appliances,to a patient's teeth using indirect bonding trays. Indirect bondingtrays can be custom shaped to fit one or more of an individual patient'steeth. The indirect bonding trays may fit the entire upper or lowerdental arch or a portion of the upper or lower dental arch. The indirectbonding tray may be formed from a physical model of the patient's teethand includes one or more spaces or wells for accommodating theorthodontic brackets to be transferred to the patient's teeth. Thephysical model may be obtained from a digital representation of thepatient's teeth, which can be digitally modified to model the preciseplacement of the orthodontic brackets on the patient's teeth. The basisof the digital representation can be acquired from a 3D intraoral scanof the patient's teeth, a physical model of the patient's teeth, and/ora negative impression of the patient's teeth. The indirect bonding traymay be formed from polyvinyl siloxane (PVS) or any other suitableelastomeric material, such as those used to form dental impressions. Theindirect bonding tray may be entirely or partially molded to a patient'steeth.

The indirect bonding tray may generally comprise a buccal side, alingual side, and an occlusal side for enclosing the one or more teeth.The indirect bonding tray may have a generally rounded or rectangularouter cross-section. The cross-section of the indirect bonding tray maybe uniform along the length of the dental arch or may vary (e.g., changeshape or dimensions). In some embodiments, the indirect bonding tray maycomprise one or more handles, which can be integrated handles, in someembodiments. FIG. 1A shows an example of an indirect bonding tray 100comprising two integral handles 102. The handles 102 may be configuredto facilitate insertion and/or placement of the indirect bonding tray100 in a patient's mouth with the use of tool. The handles 102 can allowan orthodontist to insert the indirect bonding tray 100 into the mouthof the patient without use of his or her hands. The one or more handles102 may extend (e.g., an increased height or other dimension) from thebuccal, lingual, and/or occlusal side of the indirect bonding tray 100.The handle 102 may be a flange, bridge forming a tunnel, or otherappropriate shape. The handle 102 may extend along a longitudinal axisof the indirect bonding tray 100 defined by the curvature of the dentalarch. The handle 102 may extend the entire length of the indirectbonding tray 100 or may extend only along one or more portions of theindirect bonding tray. For example, the handles 102 shown in FIG. 1Aextend only along the distal right and left ends of the arch. The one ormore handles 102 could be bilateral as shown, or unilateral in otherembodiments (e.g., the handle 102 is only disposed on the right or leftside of the arch), and render the device symmetric or asymmetric alongone, two, or more axes.

The absence of the handle 102 along the anterior portion of the indirectbonding tray 100 may facilitate access to the distal portions of thetray once the tray is inserted into the patient's mouth. Apractitioner's hand, fingers, or tools may more readily access thedistal portion of the indirect bonding tray 100 and/or the patient'sdental arch over the anterior medial portion of the indirect bondingtray 100 when the handle 102 is absent from that portion. The indirectbonding tray 100 may be formed with a variable cross section along thelength corresponding to the dental arch. For example, as shown in FIG.1A, the medial anterior portion of the tray 100 may have a smallercross-sectional area or general size than the surrounding distalportions. The smaller size of the anterior teeth may allow fabricationof the corresponding section of the indirect bonding tray 100 to be madesmaller. The smaller size of the medial anterior portion may, forexample, facilitate access to the distal portions of the mouth and tray100.

The handle 102 may comprise any suitable shape that facilitates grabbingthe indirect bonding tray 100 with an instrument. FIGS. 1Bi-1Bviischematically illustrate various examples of possible configurations ofthe handle 102. The handles 102 may be attached or integrally joined tothe indirect bonding tray 100 along the bottom of the handle 102. FIGS.1Bi-1Bv schematically illustrate cross-sections of the handles 102 takenalong the longitudinal axis aligned with the dental arch. FIG. 1Bvischematically illustrates a lingual or facial side of a handle 102. Insome embodiments, the handle 102 may be a flange. The flange may have arectangular shape, as shown in FIG. 1A. The flange may have a T-shape(FIG. 1Bi). In some embodiments, the handle 102 may be a flange havingan L-shape (FIGS. 1Bii and 1Biii). In some embodiments, the handle 102may have a U-shape to form a tunnel 103 that the orthodontist can use tograb onto with a tool. The tunnel 103 may be rounded (FIG. 1Biv),squared, rectangular (FIG. 1Bv), triangular (FIG. 1Bvi), etc. In someembodiments, the tunnels 103 may be formed in a substantiallylingual-to-facial direction rather than a mesial-to-distal direction.The handle 102 may have one or more apertures 104 disposed through it,extending, for example, from the lingual side to thefacial/labial/buccal side of the handle 102, as shown in FIG. 1Bvii. Theapertures 104 may allow the insertion of a tool or a portion of a tool,such as tweezers or graspers, through the aperture 104 to grasp theindirect bonding tray 100. The apertures 104 may be round, square,rectangular, oval, oblong, or any other suitable shape. There may be 1,2, 3, 4, 5, or more than 5 apertures 104 in each handle 102. In someembodiments, the handle 102 may comprise both a tunnel 103 and one ormore apertures 104, the one or more apertures extending through thelingual side, the facial side, or both the lingual and facial side ofthe tunnel 103. The handles 102 may be substantially rigid. The handles102 may have a degree of flexibility to allow easy bending andmanipulation by the insertion tool. In some embodiments, the handle 102is integrally molded with the indirect bonding tray 100 from the sameimpression material as the tray 100. In some embodiments, the handle 100is a solid insert (e.g., plastic or metal) that may be integrated intothe tray 100 as it is being molded or inserted into (e.g. pressed into)the tray 100 after the tray has been fabricated. In some embodiments,the handle 102 is attached to the tray 100, such as with a biocompatibleadhesive. In some embodiments, the handle 102 is removable from the tray100, such as with perforations or a frangible portion. In someembodiments, the handle 102 may include a magnet or ferromagneticmaterial to removably associate with a magnetic or metal portion of atool.

FIG. 1C, shows an example of an indirect bonding tray section 101comprising an integral handle 102. The handle 102 of FIG. 1C comprisesan aperture 104 forming a bridge along the length of the handle forfacilitating grasping by a tool 105. In some embodiments, the indirectbonding tray 100 may be sectioned into one or more pieces or sections101 (e.g., about or at least about two pieces, three pieces, fourpieces, five pieces, etc.) prior to applying the tray 100 to thepatient's mouth. In some embodiments, the indirect bonding tray 100 maybe fabricated as one or more partial sections 101 corresponding to apatient's dental arch or a portion of a patient's dental arch. Eachsection 101 may have one or more handles 102, only some of the sections101 may have one or more handles 102, or none of the sections 101 mayhave a handle 102. The sections 101 may be inserted into a patient'smouth one after another. The smaller size of the sections 101 mayfacilitate insertion of the sections 101 into the patient's mouth and/ormore accurate seating on the patient's teeth. Anatomical structures maybe taken into account in determining where to section an indirectbonding tray 100. For example, one tray could be used to place bracketson the left pre-molar and molar teeth, one on the cuspid and incisorteeth, and one on the right pre-molar and molar teeth. If upper andlower brackets are being applied, the sections 101 for the upperindirect bonding trays may be sectioned the same as or different fromthe section for the lower indirect bonding trays. FIG. 1A shows anindirect bonding tray which has been sectioned into three pieces.

The partial sections 101 may be configured to extend across distal orposterior teeth, across anterior or medial teeth, across the left teeth,across the right teeth, across the molar teeth, across the biscuspidteeth, across the bicuspid and cuspid teeth, across the incisors, acrossany adjacent combinations, or across any subset of teeth within thosesections. In general, the sections 101 and/or the handles 102 on a tray100 or section 101 may extend across one tooth, two teeth, three teeth,four teeth, five teeth, six teeth, seven teeth, eight teeth, nine teeth,ten teeth, eleven teeth, twelve teeth, thirteen teeth, fourteen teeth,fifteen teeth, or any portion of the dental arch (16 teeth) or a subsetof adjacent teeth. Accordingly, trays 100, corresponding to an entiredental arch or a portion of a dental arch, the third molar, may besectioned generally between the third molar and the second molar,between the second molar and the first molar, between the first bicuspidand the second bicuspid, between the first bicuspid and the cuspid(canine tooth), between the cuspid and the lateral incisor, between thelateral incisor and the central incisor, or between left and rightcentral incisors.

In some embodiments, pieces of an indirect bonding tray are formed byfabricating a unitary indirect bonding tray and sectioning (e.g.,cutting) the unitary tray into several pieces. The unitary indirectbonding tray may be sectioned before or after insertion of theorthodontic brackets into the tray. Some portions of the unitary bondingtray may be sectioned off and discarded where no bracket is to beapplied to the corresponding teeth. In some embodiments, portions of theindirect bonding tray corresponding to teeth without any brackets may beretained and used to facilitate seating of the indirect bonding tray inthe patient's mouth. In some embodiments, sections of the indirectbonding tray may be fabricated separately rather than sectioned from aunitary tray. In some implementations, separately fabricated sectionsmay be subsequently joined together prior to inserting the indirectbonding tray into the patient's mouth.

Indirect bonding trays may be labeled with one or more indicia ormarkers. Labeling indirect bonding trays may be especially advantageousfor sectioned indirect bonding trays in order to facilitate properregistration between the various pieces of the tray and the teeth forwhich they are configured. Labeling may prevent confusion as to whichpiece is to be applied where and promote faster and more efficienttransferring of brackets to the teeth. Labeling of the indirect bondingtrays may be accomplished by any suitable means. In some embodiments,the tray may be impregnated with a colored dye during its fabrication tocreate a multi-colored tray. The color may correspond or register to aparticular anatomical location per a color-code. This may be especiallyuseful for distinguishing between upper and lower indirect bondingtrays. The dye may be used to locally color regions of a single tray.The regions may correspond to pieces which are to be separatelysectioned. In some embodiments, identifying information, such as toothidentifiers, may be printed on the surface of the indirect bonding tray.The information may be printed using for example a marker with non-toxicink, stamped on the tray, or impressed into the tray. FIGS. 1A and 1Cdemonstrate the use of textual and graphic indicia 106 to visuallyprovide treatment information to the practitioner. The indirect bondingtray 100 shown in FIG. 1A includes identifying information on thesurface of the tray, including tooth identifiers on one side,represented by numbers aligned approximately at the correspondingposition of the identified tooth within the tray, bracket symbolsindicating the medial and occlusal side of each tooth, an indicationthat the tray is for the lower mandible (“lower”) or the “lower right”portion of the mandible (“LR”), and suggested delineations demarcatingwhere a tray could be sectioned. The delineations may be positionedapproximately between teeth so that the tray is not sectioned through aportion corresponding to a tooth. The indirect bonding trays may also belabeled with adhesive labels. The adhesive labels can for example beprinted out on a paper that has adhesive on one side. The paper may havea peel-away backing. The labels can be adhered to the surface of theindirect bonding tray. Other information that the trays can be labeledwith include details of the orthodontic treatment, such as which teethare to receive brackets, the total number of brackets, etc. Impressionsof the patient's teeth may also facilitate proper registration of theindirect bonding tray. The tray may include impressions for teeth thatare not to receive brackets in order to provide increased registrationof the tray with the patient's dental arch. In some embodiments, thelabel could include a barcode, RFID tag, or another identificationelement.

After bonding one or more brackets or other orthodontic appliances to apatient's teeth, the placement of the brackets can be digitally checkedfor accuracy. A digital representation of the patient's teethpost-application can be created from a 3D intraoral scan or by othersuitable means (e.g., a scan of a model or negative impression). The 3Dscan of the patient's teeth can be imported into software that allowsdigital manipulation and/or analysis of the 3D scan. The digital modelof the patient's teeth with applied brackets can be compared to aninitial digital plan of the patient's teeth, including proposedplacement of the brackets. For example, as illustrated in FIG. 2A, theinitial digital plan 200 for applying the brackets 201 (uncolored) andthe clinical model 202 after applying (bonding) brackets 203 (shown indark) can be digitally compared via a model 204, such as by beingsuperimposed, to allow visual evaluation of the discrepancies. FIG. 2Billustrates an image of the superimposed model 204 of FIG. 2A alone. Inembodiments, where the comparison comprises a superimposition of the twomodels 200, 202, the two models may be additively combined to form asingle volume having a continuous external surface (model 204). Thesurface of each constituent model 200, 202 may be visible only where itforms the external surface of the superimposed model 204 (is positionedrelatively outside the surface of the other constituent model). Thesuperimposed model 204 or image may be variably colored (or otherwisevisually distinguished) across different portions of its externalsurface according to which constituent model 200, 202 forms the externalsurface of the respective portion. In some implementations, in which theouter surfaces of the constituent models 202, 204 are negligiblydifferent when superimposed, the color of one of the two constituentmodels may be selected as a default or a third color may be used.

The software may compare the 3D geometry of the superimposed models 204and determine areas of discrepancy. In some embodiments, the digitalplan 200 and clinical model 202 are superimposed as different colors andthe discrepancies are not highlighted, as seen in FIGS. 2A and 2B. Thepractitioner may evaluate the superimposed model 204, for instance, byvisually discerning whether the superimposed brackets 201, 203 arealigned. For example, visual inspection may determine whether thecorresponding brackets 201, 203 from the two constituent models 200, 202substantially overlap forming the volume that would be expected from asingle bracket or whether the two constituent brackets 201, 203 aresubstantially displaced from one another. In some implementations, thesoftware may visually highlight the areas of discrepancy to allow foreasy evaluation by the orthodontist. The areas of discrepancy may bemarked as the areas on a tooth's surface where the bracket was plannedto be bonded but was not actually bonded and/or areas on a tooth'ssurface where the bracket was actually bonded but not planned to bebonded. These two types of discrepancies may be merged, such as markedby a single color, or distinguished (such as being marked by differentcolors). The software may highlight only the surface areas of the teethor may highlight the 3D space where brackets were planned to occupyand/or were not planned to occupy. The software may compare the spacesoccupied by the teeth and the brackets. The digital accuracyinformation, or any portion of the accuracy information, may be visuallydisplayed on the superimposed model 204 or on either of the individualimages (the digital plan 200 or the clinical model 202). Theorthodontist may use the accuracy information to evaluate theapplication of the orthodontic brackets and determine whether anycorrections need to be made or whether any discrepancies or inaccuraciesfall within a suitable range of error and/or are negligible. In someembodiments, the software may highlight areas of overlap rather thandiscrepancy. In some embodiments, the areas of overlap and discrepancymay be highlighted different colors. In some embodiments, thediscrepancies are depicted on either the constituent planned model orthe constituent clinical model. The discrepancies may be digitallylimited to those in the bracket positions. The anatomical features maybe assumed to be identical. Bracket positioning can be determinedrelative to anatomical landmarks.

The software may generate useful information regarding the accuracy ofbracket placement. For example, in some implementations, the softwaremay be programmed to perform an automated evaluation. The automatedevaluation may report which brackets (i.e. teeth) were or were notaccurately positioned. The software may use thresholds in displacementdistances (e.g., distances between centers of brackets or maximumdistances between corresponding points on edges of brackets from the twoconstituent models 200, 202), volumes (e.g., additive volume of brackets201, 203), or surface areas (e.g., surface area of tooth covered bybracket on the superimposed model 204) to qualify the bracketplacements. The software may indicate (e.g. via a color or a box) on oneor more of the models which brackets were within a level of toleranceand/or which brackets were outside the level of tolerance. Thepractitioner may be able to manually set the levels of tolerance and/orthey may be set by the software. Statistics regarding the placement ofthe brackets may be accumulated for one or more patients. Statisticaldata reflecting the accuracy of bracket placement may be collected basedon specific practitioners, teeth, types of brackets, bonding procedure,etc.

FIG. 3 illustrates an example of an orthodontic appliance 301 which usesnon-sliding mechanics. The archwire 303 may comprise male loops or malefasteners 304 configured to be inserted into orthodontic brackets 300 ina configuration which prevents sliding of the archwire 303 relative tothe orthodontic brackets 300. The archwire 303 may compriseinterproximal loops 302, which may be positioned between one or morepairs of adjacent brackets 300. The interproximal loops 302 may beconfigured to exert forces on the adjacent teeth to which the brackets300 are bonded. The interproximal loops 302 may be configured to exertprecision and/or customized forces on specific teeth. The forces fromopposing sides of an orthodontic bracket 300 may be accounted for inproviding a net force on each individual tooth.

Disclosed herein are systems and methods for calculating appropriateforce application vectors configured to correct malocclusion of thepatient's teeth. The system may include software for modeling the forcevectors. The vectors may be determined by comparing a digital model ofthe pre-treatment geometry of the patient's teeth comprising initialtooth positions to a digitally corrected model of the patient's teethcomprising ideal tooth positions. A vector in three-dimensional (3D)space can be calculated for each individual tooth between its initialposition (x_(i)) and its final position (x_(f)). Using the traveldistance (length of the vector) along with information about theresistance of the teeth (e.g., the resistive force of tissue and thefriction of tooth surface rubbing against one another), the tissue(e.g., the health of the gums), the jaw anatomy, and/or other patientfactors (e.g., age, sex, etc.) a force vector can be determined forrelocating the tooth from its initial position to its final position.The amount of force to be applied may be proportional to the resistance.The resistance of each tooth may be a scalar or may be a vector. Theforce may be calculated to achieve displacing the tooth across thetravel distance over a predetermined treatment time (after which thearchwire may be removed or replaced). Alternatively, using thisinformation, the expected treatment time, or time it will take torelocate the tooth from its initial position to its final position, mayalso be estimated for a given applied force. In some embodiments, thedetermined treatment plan may comprise a single application of arelatively constant force. In some embodiments, the determined treatmentplan may comprise sequential applications of various force vectors toappropriately reposition the tooth. The calculated force vector may beapplied to the tooth using an archwire. The software may be able todetermine the optimal number of treatments (e.g., archwirereplacements). The software may account for the differentforce/treatment time ratios of teeth within the dental arch indetermining appropriate forces to apply to each treated tooth such thatthe teeth are all moved into expected positions at the end of a definitetreatment time. In some implementations, the applied force may notexceed a maximum level of force to ensure patient comfort and/or safety.

As shown in FIG. 3, referenced elsewhere herein, the archwire can bebent between brackets to form interproximal loops 302, which can bebiased to expand outward or contract inward applying force against thebrackets 300 on adjacent teeth. The interproximal loops 302 may beconfigured to rotate one or more teeth. The archwire 303 can be twistedaround its axis to provide a torsional force on the adjacent bracket orbrackets 300. Brackets 300 that employ non-sliding mechanics, whereinthe archwire 303 is fixedly secured to each bracket 300 and does notslide relative to the bracket 300, may be ideal for using an archwire303 to provide custom individualized forces to each tooth. The archwire303 can comprise a shape memory alloy (e.g., nitinol). The shape-memoryarchwire 303 may be programmed with a pre-deformed shape that whenapplied to the ideal tooth positions does not cause the teeth to move.The shape memory archwire 303 may be deformed with interproximal loops302, each configured such that the transition from the deformed geometrywhen applied to the initial positioning of teeth to the pre-deformedgeometry when applied to the final positioning of teeth supplies theappropriate pre-determined force vector to the adjacent teeth to movethe teeth toward their planned final positions. The interproximal loops302 and/or twisting of the archwire 303 may be configured to be in anunbiased configuration (e.g., a preprogrammed shape memoryconfiguration) in the final position of the teeth and the initialarchwire configuration may be configured to exert the calculated force.The precise shape or configuration of the archwire in the initialconfiguration may control the force vector asserted on the adjacentteeth. More complex treatment plans may be accomplished by changingarchwires at different points throughout the treatment process to adjustthe force vectors applied on one or more of the patient's teeth.

In some implementations, the actual displacement observed or measuredafter the application of orthodontic treatment, such as with an archwirecomprising interproximal loops 302, may be used to generate feedback,which may improve the modeling of a subsequent archwire and one or moreforce vectors. Tooth positioning may be obtained by 3D intraoral scans,impressions, or any other suitable method, including those discussedelsewhere herein. FIG. 4 schematically illustrates a 3D model showingthe superimposed position of a single tooth before and after orthodontictreatment (i.e. tooth movement). The original position of the tooth isindicated in a 3D coordinate space (an XYZ coordinate grid) as X, Y, andZ (Ψ, θ, Φ). The position of the same tooth after treatment/movement isindicated by X′, Y′, and Z′. The displacement vector between the initialand final positions is indicated by ΔX, ΔY, and ΔZ. The actualdisplacement vector may be compared to the anticipated or planneddisplacement vector from which the force vector for the originaltreatment was calculated. Using this feedback, the algorithm forcalculating force vectors configured to displace teeth may be updated tomore accurately move the tooth or teeth in the next round of treatment.The difference between the planned displacement and the actualdisplacement may reflect patient-specific factors that affect how thetooth responds to force. These factors (age, sex, gum health, etc.) maybe accounted for in variables such as the tooth resistance, forinstance. For example, in a non-limiting embodiment, the resistancevariable may be adjusted such that the planned model of the priortreatment more accurately approximates the actual movement observed. Theinterproximal loops 302 in successive archwires can be continuallyimproved to optimize force delivery via the feedback loop. In someimplementations, the system may become progressively smarter (moreaccurate) as more data is input for a specific patient. Increasing thenumber of archwire replacements may increase the accuracy of treatment.For instance, the archwire may be replaced 1, 2, 3, 4, 5, 6, 7, 8, 9,10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 2728, 29, 30, or more than 30 times during the orthodontic treatment. Insome embodiments, the archwire may be replaced approximately once everymonth, 2 months, 3 months, 4 months, 5 months, 6 months, more than oncea month, or less than every 6 months. In some embodiments, the archwiremay be replaced more frequently during the initial period of orthodontictreatment so the model learns more effectively early on. In someembodiments, the archwire may be replaced at relatively frequentintervals throughout the entire orthodontic treatment. In someembodiments, the archwire may be replaced more frequently near the endof the orthodontic treatment to closely fine-tune the final positioning.The improved accuracy of treatment from the feedback model mayultimately decrease the time it takes to complete the entire orthodontictreatment, as the archwires will be less likely to overcorrect orunder-correct teeth positions and additional corrections will be lessneeded.

Disclosed herein is an archwire for applying corrective force on apatient's teeth. The archwire may apply force through brackets bonded tothe patient's teeth. The archwire may be coupled to each bracket throughnon-sliding mechanics such that the archwire is fixed relative to eachbracket, such as archwire 303. Force may be applied to move the teethvia interproximal loops 302 formed in the archwire adjacent to thebrackets, as referenced elsewhere herein. The archwire may be generallycurved to match the curvature of the patient's upper or lower dentalarch. The archwire generally extends from a right end to a left end ofthe mouth. The left end of the archwire terminates either within ordistal to the distal-most bracket positioned on the left side of thepatient's mouth. The right end of the archwire terminates either withinor distal to the distal-most bracket positioned on the right side of thepatient's mouth. Often, the distal-most brackets will be positioned on apatient's molar teeth. A non-sliding orthodontic appliance isadvantageous in that the archwire will not slide relative to thebrackets, including the most distal brackets, and therefore will notslide distally relative to the distal-most brackets. In orthodonticappliances that employ sliding-mechanics, the archwire usually slidescontinually in a distal direction as the treatment progresses. Becausethe archwire of a non-sliding orthodontic appliance cannot slidedistally relative to the distal-most brackets, the right and left endswill not inadvertently slide into and jab the patient's oral tissuecausing discomfort or pain, even as treatment progresses.

FIGS. 5A-5B schematically illustrate examples of archwires 500 withmodified distal ends. The right and left ends of the archwire mayfurther be configured to form atraumatic terminal ends 502 so as toavoid causing pain or discomfort to the patient during any transientcontact with oral tissue of the patient's mouth. Doing so may increasepatient tolerance of the orthodontic appliance. In some embodiments, theright and left ends of the archwire 500 may be bent into terminal loops504 to form atraumatic terminal ends 502. FIG. 5A schematicallyillustrates a distal end of the archwire 500 comprising a terminal loop504. The terminal loops 504 may be configured so that the ends of thearchwire are bent back on themselves and point toward the most distalbrackets, in an occlusal direction away from the patient's oral tissue,in a direction toward the tooth, or in some combination thereof. Theterminal loop 504 may be configured to direct the right and left ends ofthe archwire 500 away from the adjacent lingual or buccal/labial tissue.Any direction which positions the end of the wire 500 away from oraltissue may be employed. The terminal ends of the archwire 500 may beformed by rounded bends in the distal terminal loops which areatraumatic.

In some embodiments, the terminal ends of the archwire 500 are cappedwith bulbs/bulbous ends 506, enclosing any sharp edges of the archwire500. The bulbs 506 may be formed of a biocompatible material (e.g.,non-toxic). The bulbs 506 may be stable so that they do not degrade overthe course of the orthodontic treatment. The bulbs 506 may be formed ofa polymeric material. The bulbs 506 may be formed of an adhesive, suchas those used to bond brackets to teeth, which may be applied to theright and/or left ends of the archwire. In some embodiments, the bulbs506 may be formed of a soft elastomeric material (e.g., PVS). The endsof the archwire 500 may be dip-coated with the biocompatible material.The biocompatible material may be injected or painted onto the left andright ends of the archwire 500. In some embodiments, the biocompatiblematerial may be hardened on the ends of the archwire 500 by curing(e.g., heat cured or light cured). Curing may be accomplished throughstandard dental instruments, such as dental curing lights. In someembodiments, the biocompatible material may hardened by air-drying. Thehardened bulb 506 may be shaped during and/or after hardening to form agenerally rounded, atraumatic terminal end. For instance, the bulb 506may be shaped by standard dental tools (e.g., drills, graspers,polishers, etc.) after it has hardened to alter the shape and/or surfaceof the bulb 506. In some embodiments, the bulb 506 may be prefabricated,for instance from a rubber silicone, and contain a channel for receivingan end of the archwire 500. The right and left ends of the archwire 500can be inserted into the channel and secured therein. The archwire 500may be secured by a friction fit and may be removable from the bulb 506through application of sufficient force. In some embodiments, the end ofthe archwire 500 may be secured within the channel via a biocompatibleadhesive. The bulbous cap 506 may be heated after attaching to thedistal end of the archwire 500. Heating may shrink and/or bond thebulbous cap 506 to the archwire 500. The right and/or left ends may bebent to form atraumatic terminal ends 502 in addition to capping thewire end with bulbs 506.

In some embodiments, the right and left ends of the archwire 500 may besecured within the distal-most right and left brackets such that they donot protrude from the brackets. For example, the archwire 500 maycontain a plurality of male fasteners where each male fastener securesthe archwire to a bracket such that the archwire cannot slide laterally(in a mesial-distal direction) with respect to the bracket. The rightand left terminal ends of the archwire 500 may be formed distally to theright and left most distal male fasteners within sufficient proximity tothe male fasteners such that they do not extend out of bracket slotsconfigured to receive the archwire. For instance, the archwire mayterminate at one its distal ends at or near the point 508 indicated inFIG. 3, with respect to a distal bracket. The interaction of the malefasteners with the brackets prevents the archwire from sliding mediallywith respect to the brackets such that the archwire 500 remains securelyengaged with the brackets. In some implementations, an orthodonticappliance may be configured with brackets specially configured as thedistal-most brackets. The distal-most brackets may be configured witharchwire slots that are configured to redirect and/or retain theterminal ends of the archwire. The distal-most brackets may havearchwire slots that only open to the medial side of the bracket. Thearchwire slot may form a closed channel which prevents the distal end ofthe archwire from protruding from the bracket. For instance, the bracket300 depicted in FIG. 3 may have a distal sidewall 510 which extends (notshown) to occupy the space within the distal archwire slot of thebracket such that the archwire slot does not extend through to thedistal side of the bracket. In some embodiments the distal-most bracketsmay comprise an archwire slot having a medial opening and an openingdirected in another direction (e.g., in an occlusal direction) to directthe terminal end of the archwire away from distally positioned oraltissue. The archwire 500 may be bent during fabrication or duringintroduction into the patient's mouth in order to conform to themodified slot of the distal-most brackets. The embodiments disclosedherein may be combined, such that the right end and left end of anarchwire may be made atraumatic through the same or different means.

Disclosed herein are systems, devices, and methods for registeringnon-sliding archwires with orthodontic brackets. Orthodontic appliancesthat employ non-sliding mechanics may include an archwire withinterproximal loops and/or male fasteners, as referenced elsewhereherein. Each interproximal loop may be positioned between two malefasteners. The interproximal loop may be configured to exert preciseforces on two adjacent brackets to correct the positioning of the teethto which the brackets are bonded. The surrounding male fasteners may beused to secure the archwire to those adjacent brackets in a non-slidingmanner. Because the archwire may comprise a plurality of interproximalloops that are specifically configured with correction forces fordifferent sets of teeth and because the archwire locks into a pluralityof brackets in a non-sliding manner, the registration of the archwirewith the brackets bonded to specific teeth is not trivial, especiallycompared to orthodontic appliances that rely on sliding mechanics. Ifthe archwire is not properly registered to the respective orthodonticbrackets (is misregistered), the proper orthodontic treatment may not bedelivered. A system that allows quick and efficient registration mayalso save time and effort relative to correcting a misregisteredorthodontic appliance during delivery to the patient.

In some embodiments, the archwire is registered to the brackets using acolor registration system. The color registration system may includeplacing distinct color markings on the archwire and brackets to whichthe archwire is to be locked into. The archwire may be marked at or neara male fastener element or other locking element that corresponds to agiven bracket. The color may match that of a marking on thecorresponding bracket. In some embodiments, each fastener/bracketcombination is assigned a distinct color (e.g., red, blue, green,yellow, orange, black, etc.). In some embodiments, the same color may bereused. For instance, adjacent brackets/fasteners may be marked withalternating colors or left and right sides of the mouth may use the samecolors for corresponding left and right teeth. In some implementations,an orthodontic appliance is applied to the upper mandible and to thelower mandible. The upper and lower appliances may use distinct colorsfrom each other or the same registration patterns. In some embodiments,color markings may be used not to register the archwire with particularbrackets in an orthodontic appliance but to distinguish the upper andlower orthodontic appliances from each other or a color system may beused which performs both.

The color markings may be applied to the archwire and brackets accordingto any suitable method. The archwire and brackets may be painted withnon-toxic dyes that are suitable for coloring metal materials. Thearchwire and brackets may be subject to chemical reactions, heating,anodization, or other physical reactions that can change the color ofthe metal without significantly altering the material properties of thearchwire or bracket. The coloring of the orthodontic appliances may berelatively permanent or temporary. For instance, the coloring may washaway over time, especially under the presence of water (e.g., saliva).The archwire and brackets may be colored by attaching a colored markingelement to the devices. For instance, a colored plastic tube may beconfigured to attach to the archwire. The tube may have a diametersubstantially the same as that of the archwire. The tube may comprise aslit along its circumference that allows the tube to be slipped over thearchwire and frictionally retained thereon. The tube may be easilyremovable from the archwire and can be removed after the orthodonticappliance has been properly registered. Other suitable configurations ofcolor marking elements may be attached as well. Colored ribbons,strings, films, elastic bands, beads, etc. may be attached to thearchwire and/or brackets. The color marking elements may be removed uponregistration or may be left in place. The brackets may be marked withcolored inserts that are configured to be received within (e.g., snapinto) a portion of the geometry of the bracket. The inserts may insertinto a portion of the bracket's archwire slot or a channel for receivingthe male fastener/locking member and be removed just prior to theinsertion of the archwire into each bracket. In some embodiments, theinsert may be inserted into a residual or non-functional space withinthe bracket that is visible to the orthodontist and may need not beremoved prior to insertion of the archwire. The insert or other colorindicator on the bracket may be positioned such that is visible to thepractitioner when working in the patient's mouth but not be readilyvisible to others in daily life. For instance, the color indicator maybe relatively small, occluded by the patient's gums, positioned on adistal/mesial side of the bracket, and/or the brackets may be applied tolingual surfaces of the teeth. In such scenarios, it may be moreamenable to leave the color indicator in place. The brackets may bedesigned with custom voids or spaces for receiving a colored insert. Forexample, the brackets may be fabricated with a bore configured toreceive a custom colored peg. The peg may be configured to be insertedinto the bore such that it forms a relatively smooth surface with thebracket when fully inserted. The inserts may be permanent or removable.In some embodiments, the inserts are inserted into the bracket aftereach bracket has been designated to a particular tooth. The inserts orother color indicator may, for example, be inserted after the bracketshave been placed in an indirect bonding tray. In some implementations,the insert or other color indicator may be coupled to the brackets afterthe brackets are bonded to the teeth.

In some embodiments, a colored string, ribbon, or elastic band may beplaced around the bracket or a portion of the bracket. The string,ribbon, or elastic band may be removed just prior to registering thearchwire in each bracket. The string, ribbon, or elastic band may be cutafter registering the archwire with the bracket. In someimplementations, the string, ribbon, or elastic band may occupy thespace of a tie configured to facilitate securing the archwire to thebracket and may be removed prior to placing the tie. The presentdisclosure encompasses combinations of the colored marking systemsdisclosed herein. In some embodiments, each bracket and correspondingfastener (or identifying portion of the archwire) will be color-coded.In some embodiments, only select brackets and corresponding fastenerswill be color-coded. Registration of only a portion of the brackets withthe archwire may be sufficient to improve the efficiency of registeringthe archwire with the brackets.

Disclosed herein are system, methods, and devices for fixing an archwireto a plurality of orthodontic brackets to form an orthodontic appliancethat employs non-sliding mechanics between the archwire and thebrackets. In some embodiments, the bracket and the archwire may beconfigured to be locked together using a crimpable stop. The archwiremay comprise a stop member for engaging with a channel or slot of thebracket. The stop member may be a projection extending laterally fromthe archwire. The stop may be formed from one or more bends in thearchwire to form a male fastener with a loop, such as a U-shaped loop,V-shaped loop, teardrop-shaped loop, etc., or may be formed as anintegrated piece of material extending from the archwire. For example,the stop may be a post extending away from the archwire, a thin sheetextending from the archwire, a tube around the axis of the archwire, ora deformable portion of the archwire. The orthodontic bracket maycomprise structures configured to engage the stop and fix it in placerelative to the bracket, such that it cannot slide. For example, theorthodontic bracket may include a flange, one or more projections, atube or partial tube, or other locking element which can physicallyengage the stop. The stop, locking element, or both may be plasticallydeformable such that the stop and locking element may be crimpedtogether to secure the archwire to the bracket. The plasticallydeformable portions of the stop and/or locking element may comprisemetal that is softer and more malleable than the remainder of thearchwire/bracket and/or may be fabricated in sufficiently smalldimensions (e.g., thin cross-sections) such that they are readilyplastically deformable under the application of sufficient force. Thearchwire and bracket may be locked together in a non-slidingconfiguration by inserting the archwire into the slot such that the stopengages the locking member and by applying a physical force to crimp thestop to the locking member. The physical force may be applied via astandard orthodontic tool, such as orthodontic pliers. In someembodiments, more than one crimpable stop may be used to lock thearchwire in place with a single bracket. In some embodiments, the stopscan be used or modified for use with lower anterior brackets, such asthose disclosed in U.S. patent application Ser. No. 15/490,278 to Tonget al., which is hereby incorporated by reference in its entirety.

For example, the crimpable stop may be a male fastener wherein the loopis crimped around a projection of the bracket, such as centralprojection 306 in FIG. 3. In another example, the archwire is insertedinto a partial tube which is then crimped around the archwire or aflange from the bracket is bent around the archwire and crimped tosecure the archwire in place. In another example, a post extending fromthe archwire may be inserted into a tube or partial tube which may becrimped around the post. In yet another example, the archwire comprisesa thin flat sheet which may be deformed around a projection extendingfrom the bracket. In some embodiments, the cross-section of the archwiremay be plastically deformed where it is locked into place by thebracket, which may prevent the archwire from sliding relative to thebracket and/or from being readily removed from the bracket. In someembodiments, the crimping of the archwire to the bracket may form anorthodontic appliance which lacks some or all torque control around theaxis of the archwire.

In some embodiments, the crimpable stop is a tube that is placed aroundthe archwire. The tube may be slid over a distal end of the archwire. Insome embodiments, the tube may have a slit along the length of the tubeor the tube may only comprise a partial circumference, which may allowthe tube to be placed around the archwire without sliding it on from thedistal end. Unlike conventional orthodontic stops, the tube may beadapted to the non-sliding archwire and/or may be configured to lockinto the bracket configured to receive the non-sliding archwire. Forinstance, the tube may be non-linear. The tube may be configured alongits length or along portions of its length to resemble the shape of theinterproximal loop, the male fastener, and/or the archwire slot. Thetube may be configured to be received or partially received in thearchwire slot. The tube may be crimped before or after the archwire isplaced and/or locked into the orthodontic bracket.

FIG. 6A illustrates an example of a crimpable stop 600. The crimpablestop 600 may be a cylindrical tube as described elsewhere herein. Insome embodiments, the crimpable stop 600 may comprise a closedcircumference and may be advanced over a distal end of an archwire 602.In some embodiments, the crimpable stop 600 may be partially closed(e.g., may comprise a slit along the length of the stop) and may beadvanced (e.g., slid) over a distal end or placed directly on thearchwire 602 (i.e. the archwire 602 may be inserted into the crimpablestop 600 through the slit). In some embodiments, the crimpable stop maybe tubular but may comprise a non-cylindrical shape. For instance, thecrimpable stop 600 may have a square, rectangular, triangular, or otherpolygonal shape, or the crimpable stop may have an oblong cross-section.The crimpable stop 600 may serve as or replace a male fastener elementdescribed elsewhere herein for fixing the archwire 602 to an orthodonticbracket 604 in a non-sliding manner. The archwire 602 may besubstantially straight or linear along the portion configured to matewith the orthodontic bracket (e.g., between interproximal loops). Thearchwire slot of the bracket 604 may be substantially linear, extendingin a mesial-distal direction. The bracket 604 may comprise a recess 606configured to at least partially receive the crimpable stop 600 and toprevent or at least partially inhibit the crimpable stop 600 fromsliding in a mesial-distal when received in the recess 606. The recess606 may have a length configured to match or to be slightly larger thanthe length of the crimpable stop 600 as shown in FIG. 6. The recess 606may be formed by sidewalls of the bracket 604. The recess 606 may beformed as part of the archwire slot. The recess 606 may have a depthextended beyond that of the archwire slot configured to at leastpartially receive the crimpable stop 606.

In some embodiments, the crimpable stop 600 may be applied to thearchwire 602 prior to insertion of the archwire 602 into the orthodonticbracket 604. The crimpable stop may be crimped, as described elsewhereherein, after it is received within the recess 606. The recess 606 maybe sized or otherwise configured to allow at least partial insertion ofa crimping tool (e.g., pliers, crimpers, graspers, etc.). Crimping thecrimpable stop 600 to the archwire 602 may fixedly secure the stop 600and archwire 602 together such that the archwire cannot be axiallyadvanced (e.g., slid) through the crimpable stop 600, even under forcefrom interproximal loops. In some embodiments, the crimpable stop 600may be applied to the archwire 602 after the archwire 602 is insertedinto the orthodontic bracket 604. In some embodiments, the crimpablestop 600 may be applied and crimped before the archwire 602 is insertedinto the orthodontic bracket 604. If multiple crimpable stops 600 areused, the application and crimping sequence may be the same or differentfor each stop 600. The crimpable nature of the stop 600 may allow lastminute fine-tuning of the fixed position of the archwire within thebracket 604. This embodiment of crimpable stop may be particularlysuitable for archwires in which torqueing forces are not needed or notdesired to be exerted onto the teeth. In some embodiments, the crimpablestops may be colored. The crimpable stops may serve as the color-codedregistration indicators described elsewhere herein for registering thearchwire 602 (e.g., adjacent interproximal loops) with the properorthodontic bracket 605. In some embodiments, the stop may not becrimpable but may be fixed to the archwire 602 in another way, such asmolding, such that the stop appears similar to wire insulation.

FIG. 6B illustrates an embodiment of an archwire 602 comprisinginterproximal loops 603 and several tubular crimpable stops 600(indicated by enclosing circles) positioned between some of theinterproximal loops to fixedly secure the archwire 602 to brackets onthe lower anterior teeth.

Various other modifications, adaptations, and alternative designs are ofcourse possible in light of the above teachings. For example, featuresdisclosed in U.S. Pub. No. 2014/0120491 A1 to Khoshnevis et al. can beutilized or modified or use with embodiments as disclosed herein.Therefore, it should be understood at this time that within the scope ofthe appended claims the invention may be practiced otherwise than asspecifically described herein. It is contemplated that variouscombinations or subcombinations of the specific features and aspects ofthe embodiments disclosed above may be made and still fall within one ormore of the inventions. Further, the disclosure herein of any particularfeature, aspect, method, property, characteristic, quality, attribute,element, or the like in connection with an embodiment can be used in allother embodiments set forth herein. Accordingly, it should be understoodthat various features and aspects of the disclosed embodiments can becombined with or substituted for one another in order to form varyingmodes of the disclosed inventions. Thus, it is intended that the scopeof the present inventions herein disclosed should not be limited by theparticular disclosed embodiments described above. Moreover, while theinvention is susceptible to various modifications, and alternativeforms, specific examples thereof have been shown in the drawings and areherein described in detail. It should be understood, however, that theinvention is not to be limited to the particular forms or methodsdisclosed, but to the contrary, the invention is to cover allmodifications, equivalents, and alternatives falling within the spiritand scope of the various embodiments described and the appended claims.Any methods disclosed herein need not be performed in the order recited.The methods disclosed herein include certain actions taken by apractitioner; however, they can also include any third-party instructionof those actions, either expressly or by implication. For example,actions such as “tying a tie onto an orthodontic bracket” includes“instructing the tying of a tie onto an orthodontic bracket.” The rangesdisclosed herein also encompass any and all overlap, sub-ranges, andcombinations thereof. Language such as “up to,” “at least,” “greaterthan,” “less than,” “between,” and the like includes the number recited.Numbers preceded by a term such as “approximately”, “about”, and“substantially” as used herein include the recited numbers (e.g., about10%=10%), and also represent an amount close to the stated amount thatstill performs a desired function or achieves a desired result. Forexample, the terms “approximately”, “about”, and “substantially” mayrefer to an amount that is within less than 10% of, within less than 5%of, within less than 1% of, within less than 0.1% of, and within lessthan 0.01% of the stated amount.

What is claimed is:
 1. An indirect bonding tray for transferringorthodontic brackets to a patient's teeth, the indirect bonding traycomprising: a tray having a lingual, occlusal and buccal side formedfrom a moldable material and configured to be seated on at least aportion of the patient's dental arch, wherein the tray comprises atleast one impression of at least one of the patient's teeth and at leastone placeholder slot aligned with the at least one impression configuredto hold an orthodontic bracket; and one or more handles extending fromthe occlusal side of the tray, the one or more handles being configuredto be grasped by a tool for insertion into the patient's mouth.
 2. Theindirect bonding tray of claim 1, wherein the one or more handles extendalong only a portion of the length of the tray extending along thedental arch.
 3. The indirect bonding tray of claim 2, wherein the one ormore handles comprises a plurality of handles.
 4. The indirect bondingtray of claim 3, wherein a first handle of the plurality of handles ispositioned on a left distal side of the tray and a second handle of theplurality of handles is positioned on a right distal side of the tray,and wherein a medial anterior portion of the tray is free of handles. 5.The indirect bonding tray of claim 1, wherein the one or more handlescomprise an aperture extending through the handle from the lingual sideto the buccal side of the tray, the aperture being configured to receivea dental tool for grasping the tray.
 6. The indirect bonding tray ofclaim 1, wherein the one or more handles form a tunnel extending along alength of the handle extending along the dental arch.
 7. (canceled) 8.The indirect bonding tray of claim 1, wherein the tray is marked withindicia prescribing treatment information comprising informationregistering portions of the tray to anatomical locations of thepatient's teeth.
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 12. Theindirect bonding tray of claim 1, wherein the tray is marked withinformation demarcating a suggested position for sectioning the trayinto separate pieces.
 13. The indirect bonding tray of claim 8, whereinthe indicia comprises a color.
 14. The indirect bonding tray of claim13, wherein the color is impregnated into the tray.
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 20. (canceled)21. A system for determining the accuracy of the placement oforthodontic brackets on a patient's teeth, the system comprising: adigital representation of a planned model comprising the patient's teethand orthodontic brackets positioned on the patient's teeth in plannedpositions for orthodontic treatment; a digital representation of aclinical model of the patient's teeth comprising the patient's teeth andactual positions of the orthodontic brackets after placement onto thepatient's teeth; and a combined model created by a comparison of thedigital representations of the planned model and clinical model, whereinthe discrepancies in the planned positions and actual positions of theorthodontic brackets are visually discernible from the combined model.22. The system of claim 21, wherein the combined model is asuperimposition of a volume of the planned model and the clinical model.23. The system of claim 22, wherein different portions of a surface ofthe combined model are colored differently to reflect which of theplanned model and the clinical model forms the different portions of thesurface.
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 45. (canceled) 46.(canceled)
 47. (canceled)
 48. An orthodontic appliance comprising: anarchwire comprising at least one interproximal loop configured to exerta corrective force an orthodontic bracket; and a crimpable stop forengaging with the orthodontic bracket wherein the crimpable stop isconfigured to be crimped so as to secure the archwire to the orthodonticbracket.
 49. The orthodontic appliance of claim 48, wherein thecrimpable stop comprises a tubular member configured to be received overthe archwire, wherein crimping the crimpable stop prevents the crimpablestop from sliding with respect to the archwire.
 50. The orthodonticappliance of claim 49, wherein the crimpable stop comprises a closedcircumference and the crimpable stop is configured to be advanced over adistal end of the archwire.
 51. The orthodontic appliance of claim 49,wherein the crimpable stop comprises a slit along the length of thecrimpable stop forming a partially-closed circumference, and wherein thecrimpable stop is configured to be inserted over the archwire via theslit.
 52. The orthodontic appliance of claim 48, wherein the length ofthe crimpable stop corresponds to a length of a recess in theorthodontic bracket and the crimpable stop is configured to prevent aportion of the archwire enclosed within the crimpable stop from slidingmesially or distally beyond the recess.
 53. The orthodontic appliance ofclaim 48, wherein the crimpable stop is color coded to indicate whichorthodontic bracket it is intended to be secured within.
 54. Theorthodontic appliance of claim 52, further comprising the orthodonticbracket.